Failure to Readmit Resident After Hospitalization
Penalty
Summary
The facility failed to permit the readmission of a resident from the hospital after an involuntary hospitalization, which exceeded the bed-hold policy. The resident, who had a history of psychiatric conditions including PTSD, schizophrenia, and bipolar disorder, was initially admitted to the hospital due to aggressive behavior. Despite being deemed stable and safe to return by the hospital's psychiatric services, the facility's Nursing Home Administrator (NHA) refused to readmit the resident, citing concerns about the short duration of the hospital stay and the resident's previous behavior. The facility's policy on admission, transfer, and discharge was not adhered to, as the resident was not allowed to return despite the hospital rescinding the involuntary hospitalization. The NHA did not receive further communication from the hospital or the resident's family, and assumed the resident went with a family member. The facility's records showed an incomplete discharge notice and a bed-hold agreement that was not rescinded, indicating a lack of proper documentation and communication regarding the resident's discharge and potential readmission. Interviews with staff revealed inconsistencies in handling residents with aggressive behaviors, as other residents with similar issues were managed with 1:1 supervision and psychiatric follow-up without being involuntarily hospitalized. The facility's failure to readmit the resident after hospitalization, despite the hospital's clearance, highlights a deficiency in adhering to transfer and discharge rights, as well as a lack of consistent application of policies for managing residents with behavioral issues.
Plan Of Correction
1. Resident #2 was discharged to the hospital due to being a danger to herself and others. NHA spoke to the hospital and requested additional testing and a true evaluation be completed and then did not hear from the hospital after. Resident #2 was admitted to another Skilled Nursing Facility in the area. 2. Administrator/Designee reviewed all transfers to the hospital for the last 3 months. No other residents identified as not being permitted to return. 3. Administrator/Designee educated all licensed nurses and Social Services Director on Discharge Policies and Procedures. Administrator/Designee to conduct daily audits on all facility transfers x4 weeks and then 3 x weekly or until substantial compliance is achieved to ensure resident preferences to return to the facility are upheld. 4. Administrator/Designee to bring all audits to monthly QAPI meetings x 3 months or until substantial compliance is achieved.